Psychosocial predictors of depression and anxiety in patients with epilepsy: A systematic review

• Published in: Journal of affective disorders 2012-11, Vol.140 (3), p.222-232
• Main Authors: Gandy, Milena, Sharpe, Louise, Perry, Kathryn Nicholson
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Anxiety - psychology; Anxiety Disorders - psychology; Anxiety-Depression; Anxious; Biological and medical sciences; Coping strategies; Depression; Depression - psychology; Depressive; Depressive Disorder - psychology; Epilepsy; Epilepsy - psychology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Medical sciences; Middle Aged; Mood disorders; Nervous system (semeiology, syndromes); Neurology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Psychosocial factors; Quality Index; Risk; Risk Factors; Stigmatization; Surveys and Questionnaires; Young Adult
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2011.11.039

Abstract Background People with epilepsy (PWE) have a high chance of experiencing depression and anxiety disorders over their lifetime. However, those most at risk are unknown. Psychosocial variables have been suggested as potentially important risk factors. A systematic review was conducted in order to critically assess available evidence regarding the psychosocial predictors of depression and anxiety in adults with epilepsy. Methods Electronic databases searched were MEDLINE, PsycINFO and Web of Science. Studies were included if they assessed depressive or anxiety symptoms using a validated questionnaire, and controlled for the role of potentially important epilepsy factors. Eleven studies were identified and assessed for research standards using the Quality Index Scale (QIS). Results Ten of the eleven studies found at least one significant predictor of depression and all six studies that assessed anxiety found one or more significant predictors. Limitations Overall QIS score was only 7.5 out of 15, indicating significant design limitations of many included studies. There was also large variability between studies in measures used to assess psychosocial variables. Conclusion Studies did not support the importance of attributional theory and stigma in the development of depression in epilepsy. There was inconsistent support for the role of illness representations but likely support for the role of stress and self-efficacy. Consistent support was found for the role of coping strategies and perceived social support. Given that psychosocial factors are potentially modifiable, a better understanding of their role in the development of depression in people with epilepsy is urgently needed to guide effective treatments.